vi

DAFTAR ISI

HALAMAN JUDUL ......................................................................................................................... i

LEMBAR PENGESAHAN .......................................................................................................... ii

SURAT PERNYATAAN ............................................................................................................. iii

PRAKATA ......................................................................................................................................... iv

DAFTAR ISI ..................................................................................................................................... vi

DAFTAR SINGKATAN .............................................................................................................. ix

DAFTAR TABEL ............................................................................................................................. x

DAFTAR GAMBAR ..................................................................................................................... xi

DAFTAR LAMPIRAN ................................................................................................................ xii

INTISARI .........................................................................................................................................xiii

BAB I LATAR BELAKANG ..................................................................................................... 1

1.1 Latar Belakang .............................................................................................................. 1

1.2 Rumusan Masalah........................................................................................................ 3

1.3 Tujuan Penelitian ......................................................................................................... 3

1.4 Manfaat Penelitian ....................................................................................................... 4

BAB II TINJAUAN PUSTAKA ................................................................................................ 5

2.1 Penyakit Arteri Perifer ............................................................................................... 5

2.1.1 Definisi......................................................................................... 5

2.1.2 Etiologi......................................................................................... 6

2.1.3 Klasifikasi .................................................................................... 7

2.1.4 Patogenesis dan Patofisiologi PAP ............................................ 10

2.1.5 Faktor Risiko.............................................................................. 13

2.1.6 Diagnosis Penyakit Arteri Perifer .............................................. 15

2.2 Skor Framingham ...................................................................................................... 18

2.2.1 Definisi....................................................................................... 18

2.2.2 Prosedur Penggunaan ................................................................. 18

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2.3. Toe-brachial Index .................................................................................................... 22

2.3.1. Definisi....................................................................................... 22

2.3.1. Prosedur Penggunaan ................................................................. 23

2.4. Gagal Ginjal Kronis .................................................................................................. 24

2.4.1 Definisi....................................................................................... 24

2.4.2 Klasifikasi .................................................................................. 25

2.4.3 Faktor Risiko Kardiovaskuler .................................................... 26

2.4.4 Gagal Ginjal Kronis dengan Hemodialisa ................................. 28

2.4.5 Hubungan Gagal Ginjal Kronis dengan Penyakit Arteri

Perifer......................................................................................... 29

2.5. Kerangka Teori ........................................................................................................... 30

2.6. Kerangka Konsep ....................................................................................................... 31

2.7. Hipotesis ........................................................................................................................ 31

BAB III METODE PENELITIAN .......................................................................................... 32

3.1 Jenis dan Rancangan Penelitian ........................................................................... 32

3.2 Variabel dan Definisi Operasional ...................................................................... 32

3.2.1 Variabel ...................................................................................... 32

3.2.2 Definisi Operasional .................................................................. 32

3.3 Populasi dan Sampel ................................................................................................. 34

3.3.1 Populasi ...................................................................................... 34

3.3.2 Sampel ....................................................................................... 34

3.4 Teknik Pengambilan Sampel ................................................................................. 35

3.5 Instrument dan Bahan Penelitian ......................................................................... 36

3.5.1 Alat............................................................................................. 36

3.5.2 Pengambilan Data ...................................................................... 36

3.6 Tempat dan Waktu Penelitian ............................................................................... 36

3.7 Analisis Hasil .............................................................................................................. 37

3.8 Alur Penelitian ............................................................................................................ 38

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BAB IV HASIL PENELITIAN DAN PEMBAHASAN ................................................ 39

4.1 Hasil Penelitian ........................................................................................................... 39

4.1.1 Distribusi Karakteristik Pasien .................................................. 39

4.2 Pembahasan .................................................................................................................. 43

BAB V KESIMPULAN DAN SARAN ................................................................................ 47

5.1 Simpulan ....................................................................................................................... 47

5.2 Saran ............................................................................................................................... 47

DAFTAR PUSTAKA ................................................................................................................... 49

ix

DAFTAR SINGKATAN

PAP : Penyakit Arteri Perifer

GGK : Gagal Ginjal Kronis

TBI : Toe-brachial Index

ABI : Ankle-brachial Index

DM : Diabetes Melitus

TASC II : The Trans-Atlantic Inter-Society Consensus

LDL : Low-density Lipoprotein

HDL : High-density Lipoprotein

PDGF : Platelet-derived Growth Factor

TGF : Transforming Growth Factor

FGF : Fibroblast Growth Factor

CLI : Critical Limb Ischemia

TcPO2 : Transcutaneous Oxygen Pressure

SPP : Skin Perfusion Pressure

ESRD : End Stage Renal Disease

GFR : Glomerulus Filtration Rate

x

DAFTAR TABEL

Tabel 2.1 Klasifikasi Penyakit Arteri Perifer berdasarkan presentasi klinis ........... 8

Tabel 2.2 Tabel klasifikasi oleh Konsensus Pengelolaan Penyakit Arteri Perifer

(TASC II) ................................................................................................. 9

Tabel 2.3 Klasifikasi Komprehensif Penyakit Arteri Perifer ................................... 9

Tabel 2.4. Skor faktor risiko Skor Framingham ................................................................. 20

Tabel 4. 1 Karakteristik sampel Jenis kelamin...................................................... 39

Tabel 4. 2 Karakteristik sampel menurut usia ....................................................... 40

Tabel 4. 3 Karakteristik sampel menurut kadar Kolesterol total .......................... 40

Tabel 4. 4 Karakteristik sampel kadar Kolesterol HDL ........................................ 41

Tabel 4. 5 Karakteristik sampel Tekanan darah sistolik ....................................... 41

Tabel 4. 6 Karakteristik sampel perhitungan Skor Framingham .......................... 42

Tabel 4. 7 Karakteristik sampel kemungkinan kejadian PAP ............................... 42

Tabel 4.8 Hubungan Skor Framingham dengan kejadian Penyakit Arteri Perifer

Asimtomatik .......................................................................................................... 42

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DAFTAR GAMBAR

Gambar 2.1. Prevalensi Penyakit Arter Perifer menurut Usia ................................. 6

Gambar 2.2. Patogenesis Aterosklerosis ................................................................ 12

Gambar 2.3. Patofisiologi Aterosklerosis (M. Greif dkk., 2012) ........................... 13

Gambar 2.4. Manset Hallux dan Doppler probe pada arteri metatarsal dorsalis

ibu jari kaki ....................................................................................... 24

Gambar 2.5. Kerangka Teori .................................................................................. 30

Gambar 2. 6. Kerangka Konsep ............................................................................. 31

Gambar 3.1. Alur Penelitian................................................................................... 38

xii

DAFTAR LAMPIRAN

Lampiran 1. Data Penelitian 1 ............................................................................... 54

Lampiran 2. Data Penelitian 2 ............................................................................... 54

Lampiran 3. Data Hasil SPSS ............................................................................... 59

Lampiran 4. Ethical Clearance .............................................................................. 63

Lampiran 5. Surat Keterangan Penelitian ............................................................. 64

Lampiran 6 Surat Keterangan Selesai Penelitian .................................................. 65

Lampiran 7 Dokumentasi ...................................................................................... 66